Copyright
©The Author(s) 2021.
World J Orthop. Mar 18, 2021; 12(3): 152-168
Published online Mar 18, 2021. doi: 10.5312/wjo.v12.i3.152
Published online Mar 18, 2021. doi: 10.5312/wjo.v12.i3.152
Table 1 Coronavirus disease 2019 arthroplasty waiting list questionnaire response results
Section I: Demographic data | |
Age in yr, mean ± SD | 50.28 ± 8.9 |
Gender, n (%) | |
Male | 63 (34.05) |
Female | 122 (65.95) |
TJA, n (%) | |
TKA | 106 (57.3) |
THA | 79 (42.7) |
Awaiting TJA in mo, mean ± SD | 26.42 ± 30.1 |
Number of comorbidities, n (%) | |
0 | 59 (31.89) |
1 | 95 (51.35) |
2 | 29 (15.68) |
3 | 2 (1.08) |
Comorbidities, n (%) | |
DM | 27 (14.59) |
HPT | 89 (48.11) |
TB | 5 (2.70) |
Cardiac disease | 9 (4.86) |
Asthma | 12 (6.49) |
Lung disease | 5 (2.70) |
HIV | 18 (9.73) |
Demand for TJA despite COVID-19 pandemic, n (%) | |
Yes | 163 (88.11) |
No | 22 (11.89) |
Section II: Pain and function | |
Joint pain since postponement of TJA, n (%) | |
Decreased | 23 (12.64) |
Same | 58 (31.87) |
Increased | 101 (55.49) |
Access to pain medication, n (%) | |
Yes | 90 (72) |
No | 35 (28) |
NRS pain score, mean ± SD | 7.37 ± 2.24 |
Current state in comparison to before TJA postponement | n (%) |
Functionality due to joint pain | |
Much less | 24 (13.11) |
Less | 99 (54.1) |
Same | 50 (27.32) |
More | 5 (2.73) |
Much more | 5 (2.73) |
Walking distance | |
Much less | 30 (16.3) |
Less | 59 (32.07) |
Same | 88 (47.83) |
More | 6 (3.26) |
Much more | 1 (0.54) |
Sitting | |
Much less | 18 (9.89) |
Less | 57 (31.32) |
Same | 101 (55.49) |
More | 6 (3.3) |
Much more | 0 (0) |
Sleep | |
Much less | 25 (13.59) |
Less | 25 (13.59) |
Same | 104 (56.52) |
More | 20 (10.87) |
Much more | 10 (5.43) |
Need for pain medication | |
Much less | 8 (4.57) |
Less | 12 (6.86) |
Same | 74 (42.29) |
More | 47 (26.86) |
Much more | 34 (19.43) |
Section III: Mental health | n (%) |
Weight change since TJA postponement | |
Lost | 33 (25.98) |
Same | 56 (44.09) |
Gained | 38 (29.92) |
Feelings of isolation or loneliness | |
Yes | 59 (32.78) |
No | 121 (67.22) |
Anxiety to get infected with COVID-19 | |
No | 28 (15.3) |
Minimal | 20 (10.93) |
Neutral | 22 (12.02) |
Moderate | 47 (25.68) |
Severe | 66 (36.07) |
Anxiety to spread COVID-19 to relatives | |
No | 28 (15.64) |
Minimal | 17 (9.5) |
Neutral | 14 (7.82) |
Moderate | 39 (21.79) |
Severe | 81 (45.25) |
Anxiety about Finances due to COVID-19 | |
No | 18 (10) |
Minimal | 20 (11.11) |
Neutral | 82 (45.56) |
Moderate | 40 (22.22) |
Severe | 20 (11.11) |
Section IV: Insight | |
Understanding of healthcare system response to COVID-19 | n (%) |
Aware no elective surgery | |
Yes | 137 (74.05) |
No | 48 (25.95) |
Fair no elective surgery | |
Yes | 157 (84.86) |
No | 28 (15.14) |
Important to delay elective surgery | |
Yes | 162 (87.57) |
No | 23 (12.43) |
Knowledge of preventative measures | n (%) |
Hand washing | |
Yes | 124 (67.03) |
No | 62 (32.97) |
Social distancing | |
Yes | 124 (67.03) |
No | 62 (32.97) |
Wearing mask in public | |
Yes | 123 (66.49) |
No | 63 (33.51) |
Peri-operative patient considerations for COVID-19 | n (%) |
Routine pre-operative screening | |
Yes | 122 (89.1) |
No | 15 (10.9) |
Increased morbidity if COVID-19 positive | |
Yes | 120 (88.9) |
No | 15 (11.1) |
No visitors allowed | |
Yes | 114 (87) |
No | 17 (13) |
Increased mortality if COVID-19 positive | |
Yes | 92 (67.2) |
No | 45 (32.8) |
Patient education and counselling | |
Still demand TJA despite COVID-19 pandemic | n (%) |
Yes | 100 (54.05) |
No | 85 (45.95) |
Table 2 Pain and function responses compared between patients that wanted total joint arthroplasty despite the coronavirus disease 2019 pandemic (Yes) to patients that did not want elective surgery as soon as possible (No)1
Current state in comparison to before TJA postponement | Want TJA despite COVID-19 pandemic | P value | |
Function | Yes, n (%) | No, n (%) | |
Functionality due to joint pain | 0.002 | ||
Much less | 26 (16.05) | 0 (0) | |
Less | 89 (54.94) | 8 (38.1) | |
Same | 42 (25.93) | 8 (38.1) | |
More | 2 (1.23) | 4 (19.05) | |
Much more | 3 (1.85) | 1 (4.76) | |
Walking distance | 0.034 | ||
Much less | 27 (16.56) | 3 (14.29) | |
Less | 55 (33.74) | 3 (14.29) | |
Same | 77 (47.24) | 11 (52.38) | |
More | 3 (1.84) | 4 (19.05) | |
Much more | 1 (0.61) | 0 (0) | |
Sitting | 0.63 | ||
Much less | 15 (9.2) | 3 (15.97) | |
Less | 53 (32.52) | 4 (21.05) | |
Same | 90 (55.21) | 11 (57.89) | |
More | 5 (3.07) | 1 (5.26) | |
Sleep | 0.572 | ||
Much less | 21 (12.88) | 4 (19.05) | |
Less | 21 (12.88) | 4 (19.05) | |
Same | 94 (57.67) | 10 (47.62) | |
More | 19 (11.66) | 1 (4.76) | |
Much more | 8 (4.91) | 2 (9.52) | |
Pain | Yes, n (%) | No, n (%) | |
Joint pain | 0.037 | ||
Decreased | 20 (12.27) | 3 (15.79) | |
Same | 48 (29.45) | 10 (52.63) | |
Increased | 95 (58.28) | 6 (31.58) | |
Access to pain medication | 0.714 | ||
No | 30 (27.03) | 5 (35.71) | |
Yes | 81 (72.97) | 9 (64.29) | |
Need for pain medication | 0.05 | ||
Much less | 6 (3.87) | 2 (10) | |
Less | 8 (5.16) | 4 (20) | |
Same | 65 (41.94) | 9 (45) | |
More | 44 (28.39) | 3 (15) | |
Much more | 32 (20.65) | 2 (10) | |
Yes, mean (± SD) | No, mean (± SD) | P value | |
NRS pain score | 7.54 ± 2.02 | 3.09 ± 3.27 | < 0.000 |
Table 3 Mental health responses compared between patients that wanted total joint arthroplasty despite the coronavirus disease 2019 pandemic (Yes) to patients that did not want elective surgery as soon as possible (No)1
Mental health responses | Want TJA despite COVID-19 Pandemic, n (%) | P value | |
Yes | No | ||
Weight change since TJA postponement | 0.423 | ||
Lost | 30 (27.03) | 3 (18.75) | |
Same | 50 (45.05) | 6 (37.50) | |
Gained | 31 (27.93) | 7 (43.75) | |
Feelings of isolation or loneliness | 0.89 | ||
Yes | 51 (32.48) | 8 (34.78) | |
No | 106 (67.52) | 15 (65.22) | |
Anxiety to get infected with COVID-19 | 0.133 | ||
No | 15.43 | 14.29 | |
Minimal | 10.49 | 14.29 | |
Neutral | 9.88 | 28.57 | |
Moderate | 26.54 | 19.05 | |
Severe | 37.65 | 23.81 | |
Anxiety to spread COVID-19 to relatives | 0.016 | ||
No | 26 (16.46) | 2 (9.52) | |
Minimal | 13 (8.23) | 4 (19.05) | |
Neutral | 9 (5.7) | 5 (23.81) | |
Moderate | 35 (22.15) | 4 (19.05) | |
Severe | 75 (47.47) | 6 (28.57) | |
Anxiety about finances due to COVID-19 | 0.785 | ||
No | 16 (10.06) | 2 (9.52) | |
Minimal | 36 (22.64) | 4 (19.05) | |
Neutral | 70 (44.03) | 12 (57.14) | |
Moderate | 19 (11.95) | 1 (4.76) | |
Severe | 18 (11.23) | 2 (9.52) |
Table 4 Pain and function responses compared between the continued demand group, defer group and receptive group1
Current function in comparison to before TJA postponement | Continued demand group, n (%) | Defer group, n (%) | Receptive group, n (%) | P value |
Functionality due to joint pain | 0.043 | |||
Much less | 15 (15.31) | 0 (0) | 9 (14.06) | |
Less | 59 (60.20) | 10 (50) | 30 (46.88) | |
Same | 19 (19.39) | 6 (30) | 24 (37.5) | |
More | 2 (2.04) | 3 (15) | 0 (0) | |
Much more | 3 (3.06) | 1 (5) | 1 (1.56) | |
Walking distance | 0.118 | |||
Much less | 21 (21.21) | 2 (10) | 7 (10.94) | |
Less | 29 (29.29) | 4 (20) | 25 (39.06) | |
Same | 46 (46.46) | 11 (55) | 31 (48.44) | |
More | 2 (2.02) | 3 (15) | 1 (1.56) | |
Much more | 1 (1.01) | 0 (0) | 0 (0) | |
Sitting | 0.518 | |||
Much less | 12 (12.12) | 2 (11.11) | 4 (6.25) | |
Less | 29 (29.29) | 4 (22.22) | 23 (35.94) | |
Same | 53 (53.54) | 11 (61.11) | 37 (57.81) | |
More | 5 (5.05) | 1 (5.56) | 0 (0) | |
Sleep | 0.643 | |||
Much less | 13 (13.13) | 3 (15) | 9 (14.06) | |
Less | 15 (15.15) | 4 (20) | 6 (9.38) | |
Same | 50 (50.51) | 10 (50) | 43 (67.19) | |
More | 14 (14.14) | 1 (5) | 5 (7.81) | |
Much more | 7 (7.07) | 2 (10) | 1 (1.56) | |
Current pain in comparison to before TJA postponement | Continued demand group, n (%) | Defer group, n (%) | Receptive group, n (%) | P value |
Joint pain | 0.035 | |||
Decreased | 10 (10.10) | 3 (16.67) | 10 (15.62) | |
Same | 29 (29.29) | 9 (50) | 20 (31.25) | |
Increased | 60 (60.61) | 6 (33.33) | 34 (53.12) | |
Access to pain medication | 0.792 | |||
No | 19 | 5 | 11 | |
Yes | 51 | 9 | 30 | |
Need for pain medication | 0.068 | |||
Much less | 5 (5.26) | 2 (10.53) | 1 (1.67) | |
Less | 7 (7.37) | 4 (21.05) | 1 (1.67) | |
Same | 34 (35.79) | 9 (47.37) | 31 (51.67) | |
More | 26 (27.37) | 3 (15.79) | 17 (28.33) | |
Much more | 23 (24.21) | 1 (5.26) | 10 (16.67) | |
NRS pain score, mean (± SD) | Continued demand group | Defer group | Receptive group | P value |
7.68 ± 2.14 | 5.9 ± 3.2 | 7.24 ± 1.8 | < 0.000 |
Table 5 Responses for Insight Perception Regarding coronavirus disease 2019 compared between the continued demand group, defer group and receptive group1
Insight responses | Continued demand group, n (%) | Defer group, n (%) | Receptive group, n (%) | P value |
Healthcare system response to COVID-19 | ||||
Aware no elective surgery | 0.951 | |||
Yes | 73 (74.49) | 15 (75) | 48 (75) | |
No | 25 (25.51) | 5 (25) | 16 (25) | |
Fair no elective surgery | 0.710 | |||
Yes | 82 (82.83) | 17 (85) | 57 (89.06) | |
No | 17 (17.17) | 3 (15) | 7 (10.94) | |
Important to delay elective surgery | < 0.000 | |||
Yes | 85 (91.4) | 21 (100) | 50 (81.97) | |
No | 8 (8.6) | 0 (0) | 11 (18.03) | |
Knowledge of preventative measures | ||||
Hand washing | 0.441 | |||
Yes | 69 (69.70) | 14 (66.67) | 41 (64.06) | |
No | 30 (30.30) | 7 (33.33) | 23 (35.94) | |
Social distancing | 0.441 | |||
Yes | 69 (69.70) | 14 (66.67) | 41 (64.06) | |
No | 30 (30.30) | 7 (33.33) | 23 (35.94) | |
Wearing mask in publicYes | 68 (68.69) | 14 (66.67) | 41 (64.06) | 0.489 |
No | 31 (31.31) | 7 (33.33) | 23 (35.94) | |
Peri-operative patient considerations for COVID-19 | ||||
Routine pre-operative screening | 0.016 | |||
Yes | 94 (94) | 18 (85.71) | 44 (73.33) | |
No | 6 (6) | 3 (14.29) | 16 (26.67) | |
Increased morbidity if COVID-19 positive | 0.046 | |||
Yes | 89 (91.75) | 21 (100) | 46 (76.67) | |
No | 8 (8.25) | 0 (0) | 14 (23.33) | |
No visitors allowed | 0.018 | |||
Yes | 85 (91.4) | 18 (85.71) | 44 (73.33) | |
No | 8 (8.6) | 3 (14.29) | 16 (26.67) | |
Increased mortality if COVID-19 positive | 0.001 | |||
Yes | 77 (77) | 18 (85.71) | 26 (43.33) | |
No | 23 (23) | 2 (14.29) | 34 (56.67) |
- Citation: Pietrzak JRT, Maharaj Z, Erasmus M, Sikhauli N, Cakic JN, Mokete L. Pain and function deteriorate in patients awaiting total joint arthroplasty that has been postponed due to the COVID-19 pandemic. World J Orthop 2021; 12(3): 152-168
- URL: https://www.wjgnet.com/2218-5836/full/v12/i3/152.htm
- DOI: https://dx.doi.org/10.5312/wjo.v12.i3.152